Improving Health and Nutrition Outcomes for Children and Women Through a Convergence Model in Andhra Pradesh, India

Most programs addressing malnutrition issues in developing countries are implemented through segmented vertical approaches for health, nutrition, water and sanitation, and livelihood that often hinder inter-sectoral coordination and prevent comprehensive provision of services. Today, stakeholders recognize the importance of integrated approaches to tackle health and nutrition issues.

The Government of Andhra Pradesh, a southern Indian state, with technical assistance from FHI 360 has adopted an integrated approach to improve the nutritional outcomes for women and children statewide. This model demonstrates convergence of nutrition and livelihood initiatives within the existing health systems. The pre-intervention assessment of 173 households and 194 children (<6Years) revealed that three fourth of children and women were anemic, and half of the children were undernourished.

The first step in development of the convergence model was constitution of a state nutrition working group with experts from different disciplines representing government and non-government organizations. The group jointly reviewed the existing health and nutrition initiatives on the ground, identified areas where convergence was required and presented the findings and recommendations to the policy makers from concerned departments. The group was requested to prepare an Integrated Operational Plan for the state. Various capacity building tools, based on an integrated approach, have been developed for the health and nutrition functionaries. Issues on gender have been studied and integrated into the plan to maximize benefits for women and girls. The project will build capacities of all functionaries; establish effective referral system, integrate livelihood options, and roll out the statewide operational plan to manage malnutrition.

Evolving nature of the project, coordination with a multidisciplinary team and change in senior government officials were the major challenges. Key lessons have been to work in sync with others through a joint institutional mechanism and ensure participation and buy-in of Government right from conceptualization of the project.